Objective：To analyze the differential expression of exosomal miRNAs deriving from plasma between recurrent spontaneous abortion（RSA）and healthy-control subjects. Methods：This study enrolled 3 patients with RSA who were admitted to Nanjing Maternity and Child Health Care Hospital，and a cohort of 3 age and gestation-matched healthy-control subjects. Peripheral blood samples were collected on the first day after curettage surgery. Trancmission electron microscopy was used to identify exosomes derived from plasma samples. Sequencing was performed to identify the differentially expressed exosomal miRNAs between the RSA group and the control group. Target gene prediction，gene ontology analysis，and pathway analysis were performed for miRNAs with significant differential expression. All subjects provided written informed consent for their participation in the study. Results：By comparing with the control group， 24 significantly differential expressed exosomal miRNAs were screened in RSA group，of which 11 were down-regulated and 13 up-regulated. Conclusion：The exosomes contain abundant miRNAs which expressions are significantly different. These exosomal differential miRNAs may be a promising biomarker in the activation of RSA，needing further investigation.